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Application of the newly developed Japanese adenosine normal database for adenosine stress myocardial scintigraphy

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Abstract

Objectives

The currently available Japanese normal database (NDB) in stress myocardial perfusion scintigraphy recommended by the Japanese Society of Nuclear Medicine (JSNM-NDB) is created based on the data from exercise tests. The newly developed adenosine normal database (ADS-NDB) remains to be validated for patients undergoing adenosine stress test. We tested whether the diagnostic accuracy of adenosine stress test is improved by the use of ADS-NDB (Kanazawa University).

Methods

Of 233 consecutive patients undergoing 99mTc-MIBI adenosine stress test, 112 patients were tested. The stress/rest myocardial 99mTc-MIBI single-photon emission computed tomography (SPECT) images were analyzed by AutoQUANT 7.2 with both ADS-NDB and JSNM-NDB. The summed stress score (SSS) and summed difference score (SDS) were calculated. The agreements of the post-stress defect severity between ADS-NDB and JSNM-NDB were assessed using a weighted kappa statistic.

Results

In all patients, mean SSSs of all, right coronary artery (RCA), left anterior descending (LAD), and left circumflex (LCx) territories were significantly lower with ADS-NDB than those with JSNM-NDB. Mean SDSs in all, RCA, and LAD territories were significantly lower with ADS-NDB than those with JSNM-NDB. In 28 patients with significant coronary stenosis, the mean SSS in the RCA territory was significantly lower with ADS-NDB than that with JSNM-NDB. In 84 patients without ischemia, both mean SSSs and SDSs in all, RCA, LAD, and LCx territories were significantly lower with ADS-NDB than those with JSNM-NDB. Weighted kappa values of all patients, patients with significant stenosis, and patients without ischemia were 0.89, 0.83, and 0.92, respectively.

Conclusions

Differences were observed between results from ADS-NDB and JSNM-NDB. The diagnostic accuracy of adenosine stress myocardial perfusion scintigraphy may be improved by reducing false-positive results.

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Acknowledgments

We thank the radiological technicians of radiology department, Ogaki Municipal Hospital, Masakazu Furukawa, Fumihiko Niwa, Hirozumi Nishiwaki, for the technical assistance of scintigraphy examination.

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    Authors and Affiliations

    1. Department of Cardiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

      Shingo Harata, Satoshi Isobe, Susumu Suzuki, Hideki Ishii & Toyoaki Murohara

    2. Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan

      Itsuro Morishima, Hideyuki Tsuboi & Takahito Sone

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    1. Shingo Harata
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    2. Satoshi Isobe
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    Correspondence to Satoshi Isobe.

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    The authors declare that they have no conflicts of interest.

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    S. Harata and S. Isobe equally contributed this study and shared the first author.

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    Harata, S., Isobe, S., Morishima, I. et al. Application of the newly developed Japanese adenosine normal database for adenosine stress myocardial scintigraphy. Ann Nucl Med 29, 730–739 (2015). https://doi.org/10.1007/s12149-015-0995-1

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    • DOI: https://doi.org/10.1007/s12149-015-0995-1

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